Project Summary/Abstract The roots of cardiovascular disease (CVD), which is responsible for 32% of all deaths in the U.S., can be found during the early years, beginning perinatally. Although psychosocial interventions in populations across a wide age range have been shown to improve behavioral, mental health, and physical health outcomes, the development of effective early CVD prevention strategies and a deeper understanding of the ways in which psychosocial family factors interact to promote or reduce CVD risk are needed. The proposed project will build on the Family Foundations (FF) intervention, an ongoing NICHD-funded (PI: Feinberg, HD058529) randomized controlled trial of a perinatal intervention focused on coparenting, to examine the psychosocial pathways within the family that influence child and parent CVD risk. Additionally, we will examine potential intervention effects of FF on child and parent CVD risk. As part of the proposed project, we will augment the planned home visits (N = 294 families) which include questionnaire and family interaction data collection by adding the collection of baseline blood pressure, dried blood spot samples for the assessment of metabolic and inflammatory CVD risk markers, and important potential moderators of CVD risk. First, using these data and taking advantage of data available from three previous waves of data collection, we will develop models of interactive psychosocial influences on parent and child CVD risk. Specifically, this will include the consideration of child factors (e.g., behavioral problems), parent factors (e.g., depression), and family climate factors (e.g., parenting quality, family chaos and conflict), which we expect to interact and also contribute to CVD risk in unique ways. Second, we will test the extent to which these child, parent, and family factors mediate any effect of the FF intervention on CVD. Third, we will examine whether key external risk factors (parents? lifetime socioeconomic status (SES) and adversity and children?s lifetime SES and birth weight) moderate any associations between child, parent, and family factors and CVD risk and whether they moderate main effects of the intervention on CVD risk. This research will be conducted by an interdisciplinary team of scientists who specialize in intervention research, psychosocial influences on health, minimally invasive field-based biomarker collection, and socioeconomic health disparities. The data resulting from this project will increase our understanding of the pathways through which the psychosocial family environment influences CVD risk and whether a psychosocial intervention can reduce CVD risk. By examining the moderating role of lifetime adversity and SES, the study will further inform future intervention research to unlock the potential of such interventions to reduce SES-based CVD disparities.